肠内外营养支持对老年结直肠癌患者腹腔镜术后疗效的影响  

Influence of enteral nutrition and parenteral nutrition support on elder patients with colorectal cancer treated by laparoscopic surgery

作　　者：巩方明[1] 李冰[1] 严永峰[1] 王白石[1] 

机构地区：[1]中国人民解放军总医院肿瘤外一科,北京100853

出　　处：《中国肿瘤临床与康复》2015年第10期1231-1234,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的观察肠内营养(EN)和肠外营养(PN)对老年结直肠癌患者术后疗效的影响。方法选取134例老年结直肠癌术后患者,采用随机数字表法分为EN-PN组(n=79)和PN组(n=55),EN-PN组患者采用EN和PN联合应用,PN组患者采用单纯PN。观察两组患者的耐受情况、术后不良反应及并发症、胃肠功能恢复时间和住院时间,并比较两组患者手术前后血清总蛋白(TP)、白蛋白(ALB)、前清蛋白(PA)、转铁蛋白(TF)、总淋巴细胞数(TLC)和小野寺预后营养指数(OPNI)。结果 EN-PN组患者耐受性较好,与PN组相比,不良反应及并发症无显著增加,差异无统计学意义(P>0.05),胃肠功能恢复时间和住院时间较PN组显著减少,差异有统计学意义(P<0.05);EN-PN组患者术后第8天血清TP、ALB、PA、TF、TLC和OPNI较PN组均显著升高,差异有统计学意义(P<0.05)。PN组患者的TF、TLC和OPNI显著升高,差异有统计学意义(P<0.05)。结论对于老年结直肠癌患者,EN-PN联合应用能有效改善患者的术后营养和免疫状态,有利于患者术后恢复,且安全性较高。Objective To observe the influence of enteral nutrition（ EN） and parenteral nutrition（ PN） in elder patients with colorectal cancer. Methods Totally 134 cases of old patients with colorectal cancer in Chinese PLA General Hospital were enrolled in the study and randomly divided into the observation group（ receiving parenteral nutrition combined with enteral nutrition support,n = 79） and the control group（ receiving parenteral nutrition support,n = 55）. The tolerance,occurrence of complication,time of resumption of gastrointestinal function,hospitalization time were observed. And The total protein（ TP）,serum albumin（ ALB）,prealbumin（ PA）,transferring（ TF）,total lymph cells and Onodera prognostic nutrition index between the two groups of pre-operation and post-operation were compared. Results All the patients could tolerate EN-PN. There was no significant increase in occurrence of complication,time of resumption of gastrointestinal function and hospitalization time（ P〉0. 05）. TP,ALB,PA,TF,total lymph cells and OPNI in EN-PN group showed significant increase（ P〉0. 05）. TF、TLC,PNI of PN group showed significant decrease（ P〉0. 05）. Conclusions PN combined with EN support can make nutrition and immune state of the patients better. And it is good for patients recovery and safety.

关 键 词：老年人 结直肠肿瘤 肠内营养 肠外营养 小野寺预后营养指数 

分 类 号：R735.34[医药卫生—肿瘤]